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To the Editor: Dr Fontaine and colleagues¹ estimated that a body mass index (BMI) of 33 at age 40 years was associated with a loss of life expectancy of 2 to 3 years. In contrast, we recently reported that a BMI of 30 or more (mean BMI of 33) at age 40 years was associated with a loss of 6 to 7 years of life.² We believe that the method used by Fontaine et al underestimates the health effects of lifelong obesity. While we used a cohort life table to answer a cohort question, Fontaine et al used a period life table to answer a cohort question.

The cohort life table describes survival of a true cohort, using the age-specific mortality rates from a single cohort across many periods. This requires a population with a narrow age range at baseline and a long period of follow-up. By contrast, the period . . . [Full Text of this Article]

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